REGISTRATION OF BIRTHS, DEATHS, AND MARRIAGES (AMENDMENT ...
Births, Marriages, and Deaths
1
1227 .Bristol Royal Infirmary.—Sen. Res. O. £200. Res. Obstet. 0., H.S’.s and H.P.’s. Each £120. Also Obstetrician. Cancer hosp., Fulham-road, S.W.—Asst. to Research Dept. £700. Carshalton, Surrey, Queen Mary’s Hospital for Children.-Sen. Asst. M.O. Also Jan. Asst: M.O. £645 5s. and £515 6s. respectively. Dezvsbu.ry anll, District General Infirmary.—H.S. £200. .East.ern Dispensary, Leman-street, E.—Gynæcologist. East London Hosp. for Children, &c., Shadwell, E.—Asst. S. £50. _Elizabeth Garrett Anderson Hosp., Euston-road, N.W.—Clin Assts. Exeter, Royal Devon and Exeter Hospital.-Asst. H.S. £150. Exminster, Devon Mental Hospital.-Third Asst. M.O. £300. Gartloch l6Tental Hospital, Gartcosh, near Glasgow.-Locum Tenens. £350. General Lying-in Hospital, York-road, Lambeth, S.E.--Res. M.O. £100. Grimsby and District Hospital.—H.S. £300. Hampstead General Hospital, Haverstock Hill, N.W.—Gynæc. Hellingly, Sussex, East Sussex County Vlental Hospital.-Jun. Asst. M.O. £350. Hospital of St. John and St. Elizabeth, 40, Grove End-road, N.W. Asst. P. Kingston, Canada, Queen’s University.-Chair of Preventive Medicine.$3500.00. Leeds City Infectious Diseases Hospital, Seacroft.—Second Asst. M.O. 250. Leeds Township Infirmary.—Asst. M.O. £380. Lenham Sanatorium, Kent.—A.M.O. 8400. Lewisham Hospital, S.E.-Fourth Asst. M.O. £400. Lincoln County Hospital.-Jun. H.S. £150. Macclesfield General -Tnftrm4ary.-Sen. H.S. £200. Manchester, Ancoats Hospital.-Hon. Radiologist. -Alanchest.er Royal Infirmary.-Surg. Reg. £150. Ma.nchester, St. Mary’s Hosp.for Women and Children.-H.S. £100. Metropolitan Hospital, Kingsland-road.—Asst. Physician. Newcastle-on-Tyne Dispensary.—Res. M.O.—£350. Newcastle-upon-Tyne, Hospital for Sick Children.-Jun. Res. M.O. 2e 15 0. Newport, Mon., Royal Gwent Hospital.-H.S. £200. Nottingham General Hospital.-Two H.P.’s .&bgr;200. ’ - Queen Charlotte’s Lying-in Hospital, Marylebone-road, N.W.— Asst. Res. M.O. £860. -Queen’s Hospital for Children, Hackney-road, E.-Cas. H.S. £100. Also Asst. S. and Asst. P. .Royal London Ophthalmic Hosp., City-road, E.C.-Sen. H.S. £150. Royal National Orthopcedic Hospital, 234, Great Portland-street, W.—H.S. £150. Royal Northern Hospital, Holloway, -,V.-Cas. O. £200. .,Salop County Council.—A.M.O. £550. dSamarita.n Free Hospital for IVoiaen, Marglebone-road, N.W.- H.S. £100. Sheffield Royal Infirmary.—Two H.P.’s, H.S., Ophth. H.S., and Asst. Cas. 0. Each 150. Southampton, Royal South Hants and Soutlzampton Hospital. H.P. £150. .South London Hospital for Women, Claphana Common, S.iJ’.- H.S. and H.P. Each £100. .south Shields, Ingham Infirmary.—Sen. and Jun. H.S.’s. 200 and £150 respectively. University College Hospital, Gower-street, W.C.- Half-time M.O. 8250. West London Hospital, Hammersmith-road, JJ’.-Two H.P.’s and H.S. Each £100. West Middlesex Hospital, Isleworth.—Asst. Aled. Supt. £300. Westminster Hospital, Broad Sanctuary, S.W.-Asst. H.P. and Asst. H.S. 52. West Riding of Yorkshire County Council.—Chief Tubere. O. £750. Winchester, Royal Hampshire County Hospital.-H.P. :&bgr;150. The Chief Inspector of Factories, Home Office, London, S.W., - announces the following vacant appointments : a Chirnside (Berwick), New Southgate (Middlesex), Royton (Lancaster), Wainflect (Lincoln). Births, Marriages, and Deaths. BIRTHS. BOYD.—On June 5th, at Belsize Park-gardens, N.W’., the wife of Sidney Boyd, M.S., F.R.C.S., of Harley-street, W., of a son. HOLMES.—On June 5th, at Harley-street, W., the wife of Gordon Holmes, C.M.G., M.D., F.R.C.P., of a daughter. MARRIAGES. ’ COMPTON—HILL.—On June 10th, at the British Embassy I Church, Paris, Arthur Compton, M.B., D.So., to Ellen Hill, eldest daughter of Mr. and Mrs. James Hill, Manchester. WAYLAND-SMITH—BUTLER.—On June 7th, at St. John’s Church, Devizes, Richard Wayland-Smith, M.B., F.R.C.S. Edin., to Gladys Marjorie, only daughter of Sir Reginald Butler, Bart., and Lady Butler, of Old Park, Devizes. DEATHS. GAINER.—On Whit Sunday, at Belmont House, Thrapston, Northamptonshire, Joseph William Gainer, ILD., J.P., aged 63. LEVER.—On June 6th, at Denton House, Ifliey, Oxford, Reginald Croft Lever, Major, late R.A.M.C., aged 83. THORBURN.—On the llth inst., very suddenly, at Newbury, Victoria Park, Manchester, Augusta, Lady Thorburn, wife of Sir William Thorburn, Surgeon, and daughter of the late W. E. Melland, Esq. TURTLE.—On June 6th, at Kirkmead, Woodford, E.18, Frederick Turtle, M.D. St. Andrews, M.R.C.S. Eng., L.S.A., in his ninetieth year. N.B.—A fee of 7s. 6d. is charged for the insertion of Votices of Births, Marriages, and Deaths. , Notes, Short Comments, and Answers to Correspondents. THE ORGANISATION OF THE CARE OF MATERNITY.1 By FRANCES IVENS, M.B., M.S. LOND. IN view of the fact that present-day statistics of puerperal mortality show so little improvement on the past, it is clearly evident that midwifery has so far failed to make the same progress that medicine and surgery have made in the last few decades. But those of us who practise gynaecology are struck rather by the later results of puerperal morbidity, as they present themselves in overwhelming numbers in the out-patient departments. The organisation of a satisfactory maternity service is accordingly a very pressing need. Coördination and cooperation are required ; also further education of public opinion as to the advantages of ante- natal care. Instruction of Students in Ante-natal Care. Ante-natal care involves the health education of the pregnant woman and careful medical examination and supervision, so that abnormal conditions can be recognised and preventive measures adopted in good time. There is also scope in this work for the trained health visitor. It is obvious that special training is necessary, and it is unfor- tunate that many municipal maternity schemes have been started apart from training schools of midwifery or medicine, so that (except in the rarest instances) all this valuable teaching material is lost. There is a danger that a large amount of the care of midwifery may be isolated from the field of instruction of the medical student. The municipal maternity homes and the ante-natal clinics are not utilised to any extent for teaching, or at any rate not for the teaching of medical students. The lack of institutional facilities and the curious contempt for midwifery hitherto shown by examining bodies has pushed the practice of this subject until recently into a rushed, scrambling fortnight. This regrettable state of affairs should be remedied. The crowded student curriculum makes it a matter of urgent necessity that teaching facilities should be grouped together by the establishment and extension of teaching maternity hospitals, where all the branches of the work can be studied in their relation to each other, and in the greatest perfection of cletail. We begin, then, with the education of the mother in her home and in the ante-natal clinic. Her natural repugnance to examination must be overcome and the advantages to be obtained from pre-maternity care must be brought into a high light. Destination of Ante-natal Clinic Cases. The careful examination of the pregnant women, including pelvimetry, if performed by skilled persons with scientific exactitude, will make the ante-natal clinic into a clearing- house where the cases are sorted and grouped. The normal case will, if home conditions are favourable, stay at home and be attended by her own midwife or doctor, or both ; if she prefers it, or if home conditions are adverse, she will go into the maternity home. where there will be somewhat extended facilities. The midwife will be trained to utilise the clinic to her own and the patient’s advantage. In each maternity home will be provided beds for the use of pregnant women who require rest or treatment of a simple kind, but it need not be elaborately equipped. (’ases of abnormal pregnancy will be directed on to the central teaching hospital, where wards will be detailed for their reception where exhaustive observations can be made, and suitable treatment given. Such pathological conditions as glycosuria, oedema, albuminuria, hyperemesis, pre- eclamptic conditions, and toxæmias would be best studied in the fully-equipped teaching maternity hospital. An ambulance service must embrace the whole district served by the central maternity hospital, unobstructed by the red tape of conflicting local authorities. The scope of the present teaching maternity hospitals must be extended, if they are fully to meet the needs of their district and supply satisfactory teaching to the large numbers of students requiring instruction. The teaching maternity hospital should be situated in large centres of population provided with specialists prepared to deal with complicated condi- Abstracted from a paper read at the Congress of the Royal Institute of Public Health held at Plymouth, May 31st to June 5th, 1922, which will appear in full in the Journal of the Royal Institute.
Transcript of Births, Marriages, and Deaths
1227
.Bristol Royal Infirmary.—Sen. Res. O. £200. Res. Obstet. 0.,H.S’.s and H.P.’s. Each £120. Also Obstetrician.
Cancer hosp., Fulham-road, S.W.—Asst. to Research Dept. £700.Carshalton, Surrey, Queen Mary’s Hospital for Children.-Sen.
Asst. M.O. Also Jan. Asst: M.O. £645 5s. and £515 6s..
respectively.Dezvsbu.ry anll, District General Infirmary.—H.S. £200..East.ern Dispensary, Leman-street, E.—Gynæcologist.East London Hosp. for Children, &c., Shadwell, E.—Asst. S. £50._Elizabeth Garrett Anderson Hosp., Euston-road, N.W.—Clin Assts.Exeter, Royal Devon and Exeter Hospital.-Asst. H.S. £150.Exminster, Devon Mental Hospital.-Third Asst. M.O. £300.Gartloch l6Tental Hospital, Gartcosh, near Glasgow.-Locum
Tenens. £350.General Lying-in Hospital, York-road, Lambeth, S.E.--Res.
M.O. £100.Grimsby and District Hospital.—H.S. £300.Hampstead General Hospital, Haverstock Hill, N.W.—Gynæc.Hellingly, Sussex, East Sussex County Vlental Hospital.-Jun.
. Asst. M.O. £350.Hospital of St. John and St. Elizabeth, 40, Grove End-road, N.W.
Asst. P.Kingston, Canada, Queen’s University.-Chair of Preventive
Medicine.$3500.00.Leeds City Infectious Diseases Hospital, Seacroft.—Second Asst.
M.O. 250.Leeds Township Infirmary.—Asst. M.O. £380.Lenham Sanatorium, Kent.—A.M.O. 8400.Lewisham Hospital, S.E.-Fourth Asst. M.O. £400.Lincoln County Hospital.-Jun. H.S. £150.Macclesfield General -Tnftrm4ary.-Sen. H.S. £200.Manchester, Ancoats Hospital.-Hon. Radiologist.-Alanchest.er Royal Infirmary.-Surg. Reg. £150.Ma.nchester, St. Mary’s Hosp.for Women and Children.-H.S. £100.Metropolitan Hospital, Kingsland-road.—Asst. Physician.Newcastle-on-Tyne Dispensary.—Res. M.O.—£350.Newcastle-upon-Tyne, Hospital for Sick Children.-Jun. Res.
M.O. 2e 15 0.Newport, Mon., Royal Gwent Hospital.-H.S. £200.Nottingham General Hospital.-Two H.P.’s .&bgr;200. ’
- Queen Charlotte’s Lying-in Hospital, Marylebone-road, N.W.—Asst. Res. M.O. £860.
-Queen’s Hospital for Children, Hackney-road, E.-Cas. H.S.£100. Also Asst. S. and Asst. P.
.Royal London Ophthalmic Hosp., City-road, E.C.-Sen. H.S. £150.Royal National Orthopcedic Hospital, 234, Great Portland-street,
W.—H.S. £150.Royal Northern Hospital, Holloway, -,V.-Cas. O. £200..,Salop County Council.—A.M.O. £550.dSamarita.n Free Hospital for IVoiaen, Marglebone-road, N.W.-H.S. £100.
Sheffield Royal Infirmary.—Two H.P.’s, H.S., Ophth. H.S., andAsst. Cas. 0. Each 150.
Southampton, Royal South Hants and Soutlzampton Hospital.H.P. £150.
.South London Hospital for Women, Claphana Common, S.iJ’.-H.S. and H.P. Each £100.
.south Shields, Ingham Infirmary.—Sen. and Jun. H.S.’s. 200and £150 respectively.
University College Hospital, Gower-street, W.C.- Half-timeM.O. 8250.
West London Hospital, Hammersmith-road, JJ’.-Two H.P.’sand H.S. Each £100.
West Middlesex Hospital, Isleworth.—Asst. Aled. Supt. £300.Westminster Hospital, Broad Sanctuary, S.W.-Asst. H.P. and
Asst. H.S. 52.West Riding of Yorkshire County Council.—Chief Tubere. O. £750.Winchester, Royal Hampshire County Hospital.-H.P. :&bgr;150.The Chief Inspector of Factories, Home Office, London, S.W.,
- announces the following vacant appointments : a Chirnside(Berwick), New Southgate (Middlesex), Royton (Lancaster),Wainflect (Lincoln).
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Births, Marriages, and Deaths.BIRTHS.
BOYD.—On June 5th, at Belsize Park-gardens, N.W’., the wifeof Sidney Boyd, M.S., F.R.C.S., of Harley-street, W., ofa son.
HOLMES.—On June 5th, at Harley-street, W., the wife ofGordon Holmes, C.M.G., M.D., F.R.C.P., of a daughter.
MARRIAGES. ’
COMPTON—HILL.—On June 10th, at the British Embassy I
Church, Paris, Arthur Compton, M.B., D.So., to Ellen Hill,eldest daughter of Mr. and Mrs. James Hill, Manchester.
WAYLAND-SMITH—BUTLER.—On June 7th, at St. John’s Church,Devizes, Richard Wayland-Smith, M.B., F.R.C.S. Edin.,to Gladys Marjorie, only daughter of Sir Reginald Butler,Bart., and Lady Butler, of Old Park, Devizes.
DEATHS.GAINER.—On Whit Sunday, at Belmont House, Thrapston,
Northamptonshire, Joseph William Gainer, ILD., J.P., aged 63.
LEVER.—On June 6th, at Denton House, Ifliey, Oxford, ReginaldCroft Lever, Major, late R.A.M.C., aged 83.
THORBURN.—On the llth inst., very suddenly, at Newbury,Victoria Park, Manchester, Augusta, Lady Thorburn, wifeof Sir William Thorburn, Surgeon, and daughter of thelate W. E. Melland, Esq.
TURTLE.—On June 6th, at Kirkmead, Woodford, E.18, FrederickTurtle, M.D. St. Andrews, M.R.C.S. Eng., L.S.A., in hisninetieth year.
N.B.—A fee of 7s. 6d. is charged for the insertion of Votices ofBirths, Marriages, and Deaths. ,
Notes, Short Comments, and Answersto Correspondents.
THE ORGANISATION OF THE CARE OFMATERNITY.1
By FRANCES IVENS, M.B., M.S. LOND.
IN view of the fact that present-day statistics of puerperalmortality show so little improvement on the past, it is clearlyevident that midwifery has so far failed to make the sameprogress that medicine and surgery have made in the lastfew decades. But those of us who practise gynaecology arestruck rather by the later results of puerperal morbidity, asthey present themselves in overwhelming numbers in theout-patient departments. The organisation of a satisfactorymaternity service is accordingly a very pressing need.Coördination and cooperation are required ; also furthereducation of public opinion as to the advantages of ante-natal care.
Instruction of Students in Ante-natal Care.Ante-natal care involves the health education of the
pregnant woman and careful medical examination andsupervision, so that abnormal conditions can be recognisedand preventive measures adopted in good time. There isalso scope in this work for the trained health visitor. It isobvious that special training is necessary, and it is unfor-tunate that many municipal maternity schemes have been
started apart from training schools of midwifery or medicine,so that (except in the rarest instances) all this valuableteaching material is lost. There is a danger that a largeamount of the care of midwifery may be isolated from thefield of instruction of the medical student. The municipalmaternity homes and the ante-natal clinics are not utilisedto any extent for teaching, or at any rate not for the teachingof medical students. The lack of institutional facilities andthe curious contempt for midwifery hitherto shown byexamining bodies has pushed the practice of this subjectuntil recently into a rushed, scrambling fortnight. Thisregrettable state of affairs should be remedied. Thecrowded student curriculum makes it a matter of urgentnecessity that teaching facilities should be grouped togetherby the establishment and extension of teaching maternityhospitals, where all the branches of the work can be studiedin their relation to each other, and in the greatest perfectionof cletail.We begin, then, with the education of the mother in her
home and in the ante-natal clinic. Her natural repugnanceto examination must be overcome and the advantages to beobtained from pre-maternity care must be brought into ahigh light.
Destination of Ante-natal Clinic Cases.
The careful examination of the pregnant women, includingpelvimetry, if performed by skilled persons with scientificexactitude, will make the ante-natal clinic into a clearing-house where the cases are sorted and grouped. The normalcase will, if home conditions are favourable, stay at homeand be attended by her own midwife or doctor, or both ; ifshe prefers it, or if home conditions are adverse, she will gointo the maternity home. where there will be somewhatextended facilities. The midwife will be trained to utilisethe clinic to her own and the patient’s advantage. In eachmaternity home will be provided beds for the use of pregnantwomen who require rest or treatment of a simple kind, butit need not be elaborately equipped.
(’ases of abnormal pregnancy will be directed on to thecentral teaching hospital, where wards will be detailed fortheir reception where exhaustive observations can be made,and suitable treatment given. Such pathological conditionsas glycosuria, oedema, albuminuria, hyperemesis, pre-eclamptic conditions, and toxæmias would be best studiedin the fully-equipped teaching maternity hospital. Anambulance service must embrace the whole district servedby the central maternity hospital, unobstructed by thered tape of conflicting local authorities. The scope ofthe present teaching maternity hospitals must be extended,if they are fully to meet the needs of their district andsupply satisfactory teaching to the large numbers of studentsrequiring instruction. The teaching maternity hospitalshould be situated in large centres of population providedwith specialists prepared to deal with complicated condi-
Abstracted from a paper read at the Congress of the RoyalInstitute of Public Health held at Plymouth, May 31st toJune 5th, 1922, which will appear in full in the Journal of theRoyal Institute.
